Declining antenatal care

[Casuallydresseddeepinconversation]

I've declined midwife appts,I had a call last week to try and change my mind and another today,I feel coerced and bullied,patronised and ignored,I'm 20 weeks today and just want to be left alone, considering not going to my 20 week scan now too, the 13 week one wasn't a pleasant experience either and I feel very anti NHS,tho I don't have funds for complete private care, just feeling very emotional atm

We felt totally unsafe with our antenatal team. We found them patronising and incompetent, and on multiple occasions they reduced us to tears.

We moved to a different NHS hospital for the scans and delivery, and we used an independent midwife (private midwife) for the checkups. It was the best decision we ever made.

Independent midwife agencies are expensive, but if you can find a local freelance independent midwife it can be a lot more reasonably priced. Look for one who is still (or was until recently) also employed by the NHS. They will have contacts at the local hospitals and can advise on who to work with in the NHS to get care that makes you feel safe.

I had an independent (private) midwife (in Ireland) for a home birth, twice. She came to the house to do routine checks. I still registered at the maternity hospital that she would transfer us to if there was any emergency, and had all the routine scans there. I also thought if there was an emergency it would be better that they had me on record at the hospital. I decided not to do the hospital’s ante-natal classes as I was doing hypnobirthing, which does promote the idea that birth can sometimes be over-medicalised. My midwife agreed with my decision on the classes as they can freak some people out. I would go with the recommendations of the professional who will be overseeing your care and assisting at the delivery, as they will be focused on achieving the best outcome for mother and baby.

Yes you are. You might not feel it, but those are the facts. I say that as someone else in their late thirties TTC. Our risk profile is just higher.

Sorry, haven’t read the full thread but saw this and had to say something. I had three healthy, normal, wonderful pregnancies and then my 4th was a disaster. I had GDM that I just couldn’t get under control, lost 66lbs, was on high doses of insulin 4 times a day and the maximum dose of metformin. My placenta started failing and baby stopped growing. Had to have her out at 35+4. I only got diagnosed with it after 20 weeks too so just one GTT is not enough. Don’t be lulled into a sense of security just because your other pregnancies were fine. If I had refused antenatal care I probably would have delivered a stillborn. Please think about this carefully.

Without going through all the previous posts, I'm not really sure what you thought you would gain from posting on here to be honest. You say you don't want to be pressured, but you must have known that probably 99% of pregnant ladies gratefully accept all midwife appointments and wouldn't agree with your opinion on this one.

As someone who had appts evey 2/3 weeks and ended up being referred for regular growth scans as a result of them I don't really see your point either? You know the drill.. your in and out most of the time- for peace of Mind the baby is as well as you can tell, listen to the heartbeat if offered- is that not worth the inconvenience of going?

Absolutely this. Though it is about both the mother and the baby.

@Casuallydresseddeepinconversation - it would be extremely irresponsible of you to decline antenatal care. Please reconsider!

Towards the end of my pregnancy with DC1 I was diagnosed with cholestasis which is linked to stillbirth. Without antenatal care discussing complications I wouldn’t have thought anything was wrong.
At my 20 week scan with DC2 the sonographer could only see one kidney and a two vessel cord. The cord was the most worrying as it limited the oxygen and food the baby received possibly causing low weight. I had regular growth scans checking both the kidney and the cord. My child was born a good weight but I am thankful of the antenatal care we received. Without it anything could’ve happened. An ultrasound post birth showed a second kidney but in the wrong place. She is now under the care of a paediatric urologist to take extra care of her kidneys. I wouldn’t dream of denying my child essential healthcare.

Even if you have a private anomaly scan...if anything wrong is picked up you'll be straight back to NHS care unless you can afford to go private.

IME I've actually had better experiences with NHS scans than private scans.

You're coming across very defensive - and whilst I'm sure you're feelings are valid and you're of course entitled to feel the way you do...I can't help but wonder if you're defensiveness is because you know it's not the norm and you're being neglectful of the baby? For the few appointments you'd have is it not just worth grinning and bearing it for the sake of baby and peace of mind?

NICE is there to make sure no extra money gets spent by the NHS without a good reason.

If an antenatal check is offered, it’s because it’s been proven to improve outcomes (ie reduce dead or injured babies and mothers).

If women always got symptoms when there was a problem with the pregnancy, then there wouldn’t be antenatal checks offered to all, only to those with symptoms. Believe me the NHS would love to save money this way, if it was safe.

But the problem is there are many issues that will have no symptoms - or none until it is too late.

Actually there is good evidence that we ought to have more antenatal checks, not fewer. Several countries offer several more scans including one at c 30 weeks. Unfortunately the budget is too tight here.

I just can’t understand why you would refuse tests which could help save your baby in the event that something is wrong? What has happened to make you so anti NHS?

Honestly, I feel sorry for your baby. As a teacher of many years, I have seen my fair share of children who have been born with disabilities whose mothers failed to access antenatal care for myriad reasons. But to just refuse to engage because ‘body autonomy’ is the height of selfishness.

I do. For her unborn child. Having been in the position where things go wrong quickly, and at the end of pregnancy, and having experience of things needing attention being picked up on later scans.

I've snapped back at people calling me names and saying my older children must be neglected,they aren't and if social services want to check that they are more than welcome, the baby's father can't force me to have medical procedures i dont want,its my body and I am the patient,same as he can't force me to abort,I am competent to make my own informed decisions, I came here to.ask if anyone else had declined midwife appointments after speaking to medical professionals

Hi OP, I'm going to come at this from a different angle to most of the posters on here, because I understand your dread of engaging with the system and being being dependent on others, possibly being patronised and denied autonomy in a healthcare setting. I get it, because it's something I struggle with very much myself. I'd much prefer to have as much control as possible, sadly the NHS aren't always set up for that. I have ongoing health issues now that require me to regularly engage with the surgery, struggle to book appointments and tests and reorder prescriptions, and I cannot tell you how much I hate it all. It's visceral, and rationality has nothing to do with it.

Fortunately I have found a super GP who understands and we've worked out a way we can handle it and I can stay on my meds, which I need. For instance, I don't have my BP taken in the surgery, it will only rocket sky high and not provide any useful information, so I take it at home over a week and we record the average.

What I would say to you is this. This just a fairly short period of time in the scheme of things that you need to get through, it's not a lifetime condition, and it's both you and the baby who need a quick check up from time to time. Chances are everything will be fine, but they do them for a reason - I too ended up in hospital for a week with suspected pre-eclampsia when I had no symptoms. The consequences when things do go wrong aren't ones any of us would want to happen. Also, if you completely duck out of things, the chances are you will set hares running, eg with social services, that will be far more hassle, and last for far longer, than knuckling down and at least trying to engage somewhat with the process. I know it's a hassle, but can you just steel yourself and get it done with, then tell yourself well done and go for a coffee? Maybe take someone with you if it gives you more confidence?

I really wish you well with all this. x

Are you medically qualified? Do you know what to look out for?
Would you know if you and the baby weren't healthy?
I agree with bodily autonomy but I think occasional checks are a good idea in pregnancy and declining them may raise concerns with your Doctors and they could escalate it

Booking appt 11 weeks,scan 13 weeks, appt at 19+2(declined) scan at 21 weeks, appt after that arround weeks, apparently the appt should have been 18 weeks , so ny my reckoning from 18-28weeks is roughly 10 weeks no?

I’ve got an anti-vaxer conspiracy theorist friend and even she understood the importance of the anomaly scans, etc. Why you wouldn’t want regular, free checks to ensure a healthy pregnancy and birth is beyond me. You clearly know better than everyone else though OP, so we aren’t going to talk you round. Surely being so smart you must understand that you feeling healthy doesn’t mean there’s nothing wrong with you, or baby? It is very common to be asymptomatic but still have an illness or issue. Two previous healthy pregnancies also doesn’t indicate the third will be the same. I hope you aren’t so selfish in terms of your other children’s healthcare.

@Casuallydresseddeepinconversation Are you not planning to have any midwife at your home birth either? If you’re declining care they won’t be popping round when you’re in labour - you’d be forced to call for an ambulance and have baby in hospital.

Id make sure you definitely have the anatomy scan - preferably with NHS as at least they can use that information, they often don’t accept it with private scans.

In the kindest way - please don’t assume you know everything is ok when you don’t. Baby could have life changing things wrong and you wouldn’t know without seeing proper doctors and midwives. They are the professionals and you’re not. You might feel amazing but that doesn’t mean you are. I mean that in the nicest way possible - think of your baby and your other kids, if something were to go wrong. Could you cope looking after a disabled child? Could your 2 other kids cope without a mummy?

I'm happy that's been your experience, and I genuinely wish that for every woman giving birth - it is a vulnerable time when we need to be able to trust the people around us. But both the Ockenden Report and the Care Quality Commission report published this year make it very clear that your experience is not necessarily replicated across hospital trusts.

In its report, the CQC says problems in maternity care are so ingrained that:

• Some women, frustrated at facing such long delays in being assessed at triage, discharge themselves before they are seen.
• 65% of units are not safe for women to give birth in, 47% of trusts are rated as requiring improvement on safety and another 18% are rated as inadequate.
• Some hospitals do not record incidents that have resulted in serious harm.
• There is a widespread lack of staff and in some places a lack of potentially life-saving equipment.
• Hospitals do not always consider women’s suffering after receiving poor care.

I haven't been classes as high risk due to my age by the midwife at booking tho,surely if that was the case it would be logged somewhere

Antenatal care is not just scans. It's also monitoring for other conditions that can be symptomless and extremely serious for mother and baby.

Booking a private scan at 20 weeks is not the only consideration. What about blood pressure checks, urine checks, positioning, and growth?

You seem very convinced that complications only happen when people have risk factors but they can happen with no apparent risk factors and you feeling well is not confirmation that all is well as many pp have explained.

If you can take that onboard and still don't want to engage then that's up to you. It seems risky to me. Are you prepared for possible adverse outcomes?

If you are unhappy with the care you have received so far could you change hospital? Could you change midwife?

Things going wrong in labour can be really traumatic and part of the point of the screening is to reduce the likelihood of this. Some things can be mitigated if known about in advance.

I wish you well and hope you reconsider.

A multip doesn't have the 25 or 31 week appts so could technically go from 18 weeks to 28 weeks without an appt. That's national as recommended by NICE. For low risk women. Anyone with health problems or previous history of pregnancy issues would get more.

Most likely you are. It doesn’t mean you are too old to be a mother but it does mean your age carries with it some additional risk factors for pregnancy and birth. It could also be two pregnancies within two years as that can be a reason too. At any age as you haven’t given your body time to recover between births.

It doesn’t matter why you are high risk, whether it’s a surgery as you claim, age or back to back pregnancies or something else. You are high risk. It’s nothing to get upset about but it is definitely not a reason to disengage from antenatal care.

But you're not making an "informed" decision, and not one poster that I have seen has said that they made the same one. You're still no more convinced. Of course your partner cannot and should not force you to do anything, but I am reading between the lines correctly, then you should take his opinion into account. It's his baby too, and if you were (sorry to be blunt here) to die giving birth, the consequences would be on him.

You have a duty to your other children to take the best care of yourself possible, so that you are around to see them grow up.

How do you think you will feel if something does go wrong due to your irresponsible and downright dangerous decision?

What "medical procedures" are you on about anyway? The NHS isn't going to carry out any unless they're absolutely necessary!

This is excellent advice.

I doubt they need to log it. They have your date of birth. I speak as a mother who also gave birth aged 40, but I welcomed all the antenatal care I received.